Comparison Of Endometrial Pathology Results in Tamoxifen Or Tamoxıfen+Leuprolid Acetate Therapy in Breast Cancer Women

Year 2019, , 148 - 155, 30.06.2019

Mehmet Musa Aslan , Vedat Uğurel

https://doi.org/10.26453/otjhs.460155

Abstract

The effects
of addition of GnRH agonist on endometrial pathology and endometrial cancer
rates in tamoxifen use in breast cancer patients. A retrospective study of 204
patients who were operated for breast cancer between 1998 and 2013 and who
underwent endometrial sampling at the gynecology clinic of Trakya University
Medical Faculty, were divided into two group as treatment with tamoxifen and
tamoxifen+GnRH agonist(leuprolide acetate depot 11.25 mg ). There were no
differences between the groups in terms of endometrial thickness in the
ultrasound examination, endometrial pathology in the histopathological
examination and incidence of endometrial cancer among the premenopausal women
using tamoxifen+GnRH and the the postmenopause women using tamoxifen. We found
that the addition of a GnRH analog to the treatment of tamoxifen in breast
cancer patients did not increase the risk of premalignant lesion and
endometrium ca in premenopausal women.

Keywords

Breast cancer, tamoxifen, GnRH analgesic, leuprolide acetate, endometrial pathology, endometrial cancer

Meme Kanserli Kadınlarda Tamoksifen veya Tamoksifen+Leuprolid Asetat Tedavisi Alanlarda Endometrial Patoloji Sonuçlarının Karşılaştırılması

Abstract

Meme kanserli olgularda
tamoksifen kullanımına GnRH agonisti eklenmesinin endometrial patoloji ve
endometrial kanser oranlarına etkisinin araştırılması planlandı. Retrospektif
yapılan çalışma 1998 ile 2013 yılları arasında meme kanseri nedeniyle opere
olan ve Trakya Üniversitesi Tıp Fakültesi Hastanesi jinekoloji polikliniğinde
endometriyal örnekleme yapılan 204 olgu, sadece tamoksifen alanlar ve
tamoksifen+GnRH agonisti(leuprolide acetate depot 11,25 mg) tedavisi alanlar
olarak iki gruba ayrıldı. Tamoksifen ile birlikte GnRH agonisti kullanan
premenopozal kadınlar ile tamoksifen kullanan postmenopozal kadınlar arasında
ultrason incelemesinde endometrial kalınlık, histopatolojik incelemede
endometrial patoloji bulunma ve endometrial kanser görülme oranları açısından
gruplar arasında fark bulunmadı. Meme kanserli hastalarda tamoksifen tedavisine
GnRH anoloğunun eklenmesi premenopozal kadınlarda premalign lezyon ve
endometrium ca riskini arttırmadığını saptadık.

Keywords

Meme kanseri, tamoksifen, GnRH analoğu, leuprolid asetat, endometrial patoloji, endometrial kanser

References

• Committee Opinion No.601: Tamoxifen and uterine cancer. Obstet Gynecol. 2014;123(6):1394-1397.
• Chen JY, Kuo SJ, Liaw YP, et al. Endometrial cancer incidence in breast cancer patients correlating with age and duration of tamoxifen use: a population based study. Journal of Cancer. 2014;5:151-155.
• Deligdisch L, Kalir T, Cohen CJ, de Latour M, Le Bouedec G, Penault-Llorca F. Endometrial histopathology in 700 patients treated with tamoxifen for breast cancer. Gynecologic oncology. 2000;78:181-186.
• Kim J, Kim M, Lee JH, et al. Ovarian function preservation with GnRH agonist in young breast cancer patients: does it impede the effect of adjuvant chemotherapy? Breast. 2014;23(5):670-675.
• Moore HC, Unger JM, Phillips KA, Boyle FM, Hitre E, Porter DJ, et al. Phase III trial (Prevention of Early Menopause Study [POEMS]-SWOG S0230) of LHRH analog during chemotherapy (CT) to reduce ovarian failure in early-stage, hormone receptornegative breast cancer: an international Intergroup trial of SWOG, IBCSG, ECOG, and CALGB (Alliance). J Clin Oncol. 2014;32:15s (Suppl.; abstr LBA505).
• Noci I, Coronnello M, Borri P, et al. Inhibitory effect of luteinising hormone-releasing hormone analogues on human endometrial cancer in vitro. Cancer Lett. 2000,13;150(1):71-78.
• Sica G, Schinzari G, Angelucci C, Lama G, Iacopino F. Direct effects of GnRH agonists in human hormone-sensitive endometrial cells. Mol Cell Endocrinol. 2001,15;176(1-2):121-128.
• Fisher B, Costantino JP, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998;90:1371–1388.
• Cheng WF, Lin HH, Torng PL, Huang SC. Comparison of endometrial changes among symptomatic tamoxifen- treated and nontreated premenopausal and postmenopausal breast cancer patients. Gynecol Oncol. 1997;66:233–237.
• Committee on Practice Bulletins Gynecology. Practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductiveaged women. Obstet Gynecol 2012; 120:197. Reaffirmed 2016.